国家监测 2017-2020 年达巴万星、替考拉宁、替加环素、依拉环素、奥马环素和其他比较抗生素的抗菌药物敏感性以及成人侵袭性肺炎链球菌分离株血清型分布：台湾多中心抗菌药物耐药监测计划（SMART）的结果。
National surveillance of antimicrobial susceptibilities to dalbavancin, telavancin, tedizolid, eravacycline, omadacycline and other comparator antibiotics and serotype distribution of invasive Streptococcus pneumoniae isolates in adults: results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART) programme in 2017-2020.
机构信息
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, and Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.
出版信息
J Glob Antimicrob Resist. 2021 Sep;26:308-316. doi: 10.1016/j.jgar.2021.07.005. Epub 2021 Jul 18.
OBJECTIVES
The aim of this study was to investigate the trends in serotypes and in vitro antimicrobial susceptibility of Streptococcus pneumoniae causing adult invasive pneumococcal disease (IPD) to dalbavancin, telavancin, tedizolid, eravacycline, omadacycline and other comparator antibiotics from 2017-2020 following implementation of the 13-valent pneumococcal conjugate vaccine (PCV-13) and during the COVID-19 (coronavirus disease 2019) pandemic.
METHODS
During the study period, 237 S. pneumoniae isolates were collected from non-duplicate patients, covering 15.0% of IPD cases in Taiwan. Antimicrobial susceptibility testing was performed using a Sensititre® system. A latex agglutination method (ImmuLex™ Pneumotest Kit) was used to determine serotypes.
RESULTS
Susceptibility rates were high for vancomycin (100%), teicoplanin (100%) and linezolid (100%), followed by ceftaroline (non-meningitis) (98.3%), moxifloxacin (94.9%) and quinupristin/dalfopristin (89.9%). MIC and MIC values of dalbavancin, telavancin, tedizolid, eravacycline and omadacycline were generally low. Non-vaccine serotype 23A was the leading cause of IPD across the adult age range. Isolates of serotype 15B were slightly fewer than those of PCV-13 serotypes in patients aged ≥65 years. The overall case fatality rate was 15.2% (36/237) but was especially high for non-PCV-13 serotype 15B (21.4%; 3/14). Vaccine coverage was 44.7% for PCV-13 and 49.4% for the 23-valent pneumococcal polysaccharide vaccine (PPSV-23), but was 57% for both PCV-13 and PPSV-23.
CONCLUSION
The incidence of IPD was stationary after PCV-13 introduction and only dramatically decreased in the COVID-19 pandemic in 2020. The MIC and MIC values of dalbavancin, telavancin, tedizolid, eravacycline, omadacycline were generally low for S. pneumoniae causing adult IPD.
目的
本研究旨在调查 2017 年至 2020 年 13 价肺炎球菌结合疫苗（PCV-13）实施后及 COVID-19（2019 年冠状病毒病）大流行期间，导致成人侵袭性肺炎球菌病（IPD）的肺炎链球菌血清型和体外抗菌药物敏感性趋势，所用药物包括达巴万星、替拉万星、替加环素、艾拉霉素、奥马环素和其他比较抗生素。
方法
研究期间，从非重复患者中收集了 237 株肺炎链球菌分离株，占台湾 IPD 病例的 15.0%。采用 Sensititre®系统进行抗菌药物敏感性测试。乳胶凝集法（ImmuLex™Pneumotest Kit）用于确定血清型。
结果
万古霉素（100%）、替考拉宁（100%）和利奈唑胺（100%）的敏感性率较高，其次是头孢洛林（非脑膜炎）（98.3%）、莫西沙星（94.9%）和奎奴普丁/达福普汀（89.9%）。达巴万星、替拉万星、替加环素、艾拉霉素和奥马环素的 MIC 和 MIC 值通常较低。非疫苗血清型 23A 是各年龄段成人 IPD 的主要病因。65 岁以上患者中，15B 血清型分离株略少于 PCV-13 血清型。总的病死率为 15.2%（36/237），但非 PCV-13 血清型 15B （21.4%；3/14）的病死率特别高。PCV-13 疫苗覆盖率为 44.7%，23 价肺炎球菌多糖疫苗（PPSV-23）为 49.4%，但 PCV-13 和 PPSV-23 均为 57%。
结论
PCV-13 引入后 IPD 发病率保持稳定，仅在 2020 年 COVID-19 大流行期间急剧下降。导致成人 IPD 的肺炎链球菌对达巴万星、替拉万星、替加环素、艾拉霉素、奥马环素的 MIC 和 MIC 值通常较低。
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